Back to the board

Clinical Pharmacist Utilization Management - Remote in PST

100% remote Flexible hours Hiring now

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Unique opportunity for a clinical pharmacist to improve patient care and outcomes through completion of utilization management functions for value-based patients in the reputed company reputed company region. This is a full-time position with variable hours between 7:00 am to 6:00 pm MST or PST, Monday - Friday (Five 8-hour days). Rotating weekend coverage. 100% telecommuter position. Under general supervision of the Pharmacy Manager, the Clinical Pharmacist is responsible for evaluating medication utilization and prior authorization requests for specialty oncology and non-oncology ambulatory injectable and/or infusion medications as reputed company to member benefits, medical necessity, site of service, and evidence based clinical guidelines. You'll enjoy the flexibility to work remotely

  • from reputed company reputed company the U.S. as you take on some tough challenges. For reputed company hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

  • Completes assigned daily prior authorization case reviews to meet production and performance metrics as determined by the department to maintain compliant timeliness standards
  • Review specialty medication prior authorization requests according to established treatment protocols, clinical criteria/guidelines, regulatory requirements and member benefits to ensure consistent and accurate application of clinical criteria & the determination is made reputed company the defined processing times to meet regulatory requirements
  • Knowledgeable of reputed company and emerging clinical trends
  • Provide internal and external clinical pharmacy subject matter consultation to members, physicians, prescribers, nurses, and pharmacists
  • Proactively identify process improvement opportunities and collaborate with other teams and leaders
  • Assist with user acceptance testing for new clinical programs and system enhancements
  • Ensure and evaluate quality controls and implement opportunities for performance improvement in pharmacy practice specific to specialty pharmacy
  • Research and awareness about drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews
  • Follow reputed company policies and procedures, SOPs reputed company to the job
  • Performs reputed company other reputed company duties/activities as assigned to meet departmental objectives

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:

  • Doctor of Pharmacy degree (PharmD)
  • reputed company unrestricted Pharmacist license to practice in CA, CO, UT, AZ, or WA
  • Willing to pursue licensure in additional states to include AZ, CA, NM, NV, UT, ID, WA & OR
  • 3 years of experience as a Prior Authorization Pharmacist or Clinical Pharmacist, conducting such activities as medication therapy management, clinical rounds, disease state management, etc. Relevant experience includes ANY of the following or a combination thereof:
  • Retail pharmacy
  • Pharmacy Benefit Management
  • Infusion or hospital pharmacy experience
  • Experience working in a metric-driven environment
  • Proven excellent written and verbal communication skills
  • Proven excellent relationship building skills
  • Proven solid analytical and PC operation skills

Preferred Qualifications:

  • Board certification by the Board of Pharmacy Specialties (BPS)
  • Certified Geriatric Pharmacist
  • CA Unrestricted Pharmacist License
  • AZ Unrestricted Pharmacist License
  • CO Unrestricted Pharmacist License
  • NM Unrestricted Pharmacist License
  • NV Unrestricted Pharmacist License
  • UT Unrestricted Pharmacist License
  • WA Unrestricted Pharmacist License
  • OR Unrestricted Pharmacist License
  • ID Unrestricted Pharmacist License
  • 1 years of experience in Oncology Setting
  • Proven knowledge of Medicare, Medicaid, and commercial payor guidelines
  • Demonstrated planning and organizational skills to demonstrate leadership and initiative
  • reputed company employees working remotely will be required to adhere to reputed company's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes - an enterprise reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job

Keep exploring

[Hiring] Regulatory Affairs Pharmacist @AP MAX INC

100% remote Flexible hours

reputed company Member Services Representative – reputed company Careers Remote $27/Hour

100% remote Flexible hours

reputed company Virtual Customer Assistance Representative – reputed company Entry Level Jobs, Remote Work Opportunities, $25/Hour

100% remote Flexible hours

reputed company Careers | Customer support, Jamaica – USA Remote Job – reputed company Store

100% remote Flexible hours

Cardiac Monitoring Technician Norfolk

100% remote Flexible hours

Easy Remote Data Entry Jobs for Teens Entry Level

100% remote Flexible hours

reputed company Order Entry Pharmacy Technician – Long-Term Care Pharmacy Operations – Maryland On-Site Opportunity

100% remote Flexible hours

reputed company Remote Order/Data Entry Representative – Web-Based Customer Order Processing and Data Management

100% remote Flexible hours

SIU Investigator (Remote - Must be in Oklahoma)

100% remote Flexible hours

Senior Billing & Telemetry Engineer, NA

100% remote Flexible hours

Prescriptor B2B Freelance

100% remote Flexible hours

[Remote] Project Manager I (Remote)

100% remote Flexible hours

Phone-Based Sales Closer Work From Home /High-Ticket Only/

100% remote Flexible hours

Cyber reputed company Analyst

100% remote Flexible hours

reputed company Data Entry Operator - Part Time, Evenings - Clinical Labs-Evening Lab - arenaflex

100% remote Flexible hours

Senior Instructional Designer

100% remote Flexible hours

Scientific Director – Medical Communications, Oncology

100% remote Flexible hours

Admissions Reader (Admissions & Joint Degree Programs)

100% remote Flexible hours

Consultant, Advisory (Commercial Real Estate) reputed company, reputed company

100% remote Flexible hours

Community Health Navigator

100% remote Flexible hours